AZHIN: Principles of Integrated Care: Levels of Integration

Understanding the Levels of Integration

A goal of many projects related to integrated care is to expand the level of integration. The resources below can help you understand the levels of integration and can assist with the movement to different levels.

The Standard Framework for Levels of Integration - 2013
The original SAMHSA‑HRSA Framework. Helps primary and behavioral health care provider organizations improve outcomes by helping them understand where they are on the integration continuum.
The Comprehensive Health Integration (CHI) Framework - 2025
Released in February 2025 by the Center of Excellence for Integrated Health Solutions. It builds on the SAMHSA levels, defining three concrete integration stages within physical and behavioral health systems. Includes a white paper, self-assessment tools, and examples.
Renewed Development Model for Integrated Care (DMIC) – March 2025
A peer‑reviewed systematic update to the original DMIC (Minkman et al., 2011), validating it across 179 studies and adding 20 new elements such as digital services, ethics-driven collaboration, and community ecosystem alignment. Although not directly tied to CHIS, the DMIC’s four developmental phases (from design to transformation) closely mirror the CHIS progression and offer evaluative measures of how organizations mature.
Developing Integrated Care: Towards a development model for integrated care
The original Minkman (2011) study

How to Demonstrate Movement Through Levels of Integration

Download and review the Standard Framework for Levels of Integration (2013) to establish baseline integration.
Use the CHI 2025 self‑assessment tools to benchmark current stage and gaps.
Map your progress against the levels—understand shifts in system integration, formalization of care teams, shared culture, infrastructure, and financing.
Cite real-world examples from DMIC validation studies and CHI/CIHS case studies to show how programs have successfully moved to higher paces.